NPI | 1275581613 |
---|---|
Former Name | JENNIFER GLESSNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305204057) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: PA PT016733) |
Enumeration Date | 2006-05-05 |
Last Update Date | 2007-07-08 |